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Transcript of Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El...
![Page 1: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/1.jpg)
BASICS OF WAVEFORM
INTERPRETATION
RET 2284
Principles of Mechanical Ventilation
![Page 2: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/2.jpg)
![Page 3: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/3.jpg)
Objectives
• Identify graphic display options
provided by mechanical ventilators.
• Describe how to use graphics to
more appropriately adjust the patient
ventilator interface.
![Page 4: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/4.jpg)
Introduction
Monitoring and analysis of graphic display of
curves and loops during mechanical
ventilation has become a useful way to
determine not only how patient are being
ventilated but also a way to assess problems
occurring during ventilation.
![Page 5: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/5.jpg)
Uses of Flow, Volume, and Pressure
Graphic Display
• Confirm mode functions
• Detect auto-PEEP
• Determine patient-ventilator synchrony
• Assess and adjust trigger levels
• Measure the work of breathing
• Adjust tidal volume and minimize overdistension
• Assess the effect of bronchodilator administration
• Detect equipment malfunctions
• Determine appropriate PEEP level
![Page 6: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/6.jpg)
Uses of Flow, Volume, and Pressure
Graphic Display
• Evaluate adequacy of inspiratory time in pressure
control ventilation
• Detect the presence and rate of continuous leaks
• Assess inspiratory termination criteria during Pressure
Support Ventilation
• Determine appropriate Rise Time
![Page 7: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/7.jpg)
Measured Parameters
Flow
Pressure
Volume
Time
![Page 8: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/8.jpg)
Most Commonly Used Waveforms
(Scalars)
• Pressure vs. Time
• Flow vs. Time
• Volume vs. Time
![Page 9: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/9.jpg)
Pressure vs. Time Curve
1 2 3 4 5 6
30
Sec
PawcmH2O
A BC
PIP
Baseline
Mean Airway Pressure
-10
![Page 10: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/10.jpg)
Pressure-Time Curve
1 2 3 4 5 6
20
Sec
Paw
cmH2O
Pressure VentilationVolume Ventilation
![Page 11: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/11.jpg)
Patient Triggering
1 2 3 4 5 6
30
Sec
PawcmH2O
-10
![Page 12: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/12.jpg)
Adequate Flow During
Volume-Control Ventilation
30
Time (s)
-10
1 2
awPcmH2O
Adequate flow
3
![Page 13: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/13.jpg)
Inadequate Flow During
Volume-Control Ventilation
30
Time (s)
-10
1 2
awPcmH2O
Adequate flow
Flow set too low
3
![Page 14: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/14.jpg)
Patient/Ventilator SynchronyVolume Ventilator Delivering a Preset Flow and Volume
Adequate Flow
1 2 3 4 5 6
-20
SecPaw
cmH2O
![Page 15: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/15.jpg)
Patient/Ventilator SynchronyThe Patient Outbreathing the Set Flow
Air Starvation
1 2 3 4 5 6
-20
SecPaw
cmH2O
![Page 16: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/16.jpg)
Plateau Time
Inadequate plateau time
-20
1 2 3 4 5 6
30
SEC
Paw
cmH2O
![Page 17: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/17.jpg)
Adequate Plateau Time
-20
1 2 3 4 5 6
30
SEC
Paw
cmH2O
Plateau Time
![Page 18: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/18.jpg)
Flow vs.Time Curve
1 2 3 4 5 6
SEC
120
120EXH
INSP
V.
LPM
Inspiration
![Page 19: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/19.jpg)
Flow vs.Time Curve
1 2 3 4 5 6
SEC
120
120EXH
INSP
V.
LPM
Inspiration
Expiration
![Page 20: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/20.jpg)
Flow vs.Time Curve
1 2 3 4 5 6
SEC
120
120EXH
INSP
Inspiration
V.
LPM
Constant Flow Descending Ramp
![Page 21: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/21.jpg)
Flow-Time Curve
1 2 3 4 5 6
SEC
120
120EXH
INSP
Insp. Pause
Expiration
V.
LPM
![Page 22: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/22.jpg)
Inspiratory Time
Short Normal Long
![Page 23: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/23.jpg)
1 2 3 4 5 6
SEC
120
-120
V.
LPM
Expiratory Flow Rate and Changes in Expiratory Resistance
![Page 24: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/24.jpg)
A Higher Expiratory Flow Rate and a Decreased Expiratory Time Denote a Lower
Expiratory Resistance
1 2 3 4 5 6
SEC
120
120
V.
LPM
![Page 25: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/25.jpg)
Obstructed Lung
Delayed flow return
![Page 26: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/26.jpg)
Pressure-Time and Flow-Time Curves
1 2 3 4 5 6
20
Sec
Paw
cmH2O
Expiration
V.
Volume Ventilation
![Page 27: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/27.jpg)
Pressure-Time and Flow-Time Curves
Different Inspiratory Flow Patterns
1 2 3 4 5 6
20
Sec
Paw
cmH2O
Expiration
V.
Volume Ventilation
Inspiration
![Page 28: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/28.jpg)
20
Pressure-Time and Flow-Time Curves
1 2 3 4 5 6
Sec
Paw
cmH2O
V.
Pressure Ventilation
Inspiratory Time
Volume Ventilation
![Page 29: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/29.jpg)
Rise Time
How quickly set pressure is reached
![Page 30: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/30.jpg)
Time
Minimal Pressure Overshoot
Pressure Relief
Slow rise Moderate rise Fast rise
P
V.
Flow Acceleration Percent
Rise Time
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Patient / Ventilator SynchronyVolume Ventilation Delivering a Preset Flow and Volume
Adequate Flow
1 2 3 4 5 6
30
-20
SecPaw
cmH2O
![Page 32: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/32.jpg)
Air Starvation
1 2 3 4 5 6
30
-20
SecPaw
cmH2O
Patient -Ventilator SynchronyThe Patient Is Outbreathing the Set Flow
![Page 33: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/33.jpg)
If Peak Flow Remains the Same, I-Time Increases: Could Cause Asynchrony
LPM
1 2 3 4 5 6
SEC
120
-120
V.
![Page 34: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/34.jpg)
Changing Flow Waveform in Volume Ventilation: Effect on Inspiratory Time
1 2 3 4 5 6
SEC
120
-120
V.
LPM
![Page 35: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/35.jpg)
Increased Peak Flow: Decreased Inspiratory Time
1 2 3 4 5 6
SEC
120
-120
V.
LPM
![Page 36: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/36.jpg)
Note: There can still be pressure in the lung behind
airways that are completely obstructed
Detecting Auto-PEEP
LPM
Zero flow at end exhalation indicates
equilibration of lung and circuit pressure
1 2 3 4 5 6
SEC
120
-120
V.
![Page 37: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/37.jpg)
Detecting Auto-PEEP
The transition from expiratory to inspiratory
occurs without the expiratory flow returning
to zero
1 2 3 4 5 6
SEC
120
120
V.
LPM
![Page 38: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/38.jpg)
Volume vs.Time Curve
Inspiration
SEC
800 ml
2 3 4 5 61
VT
![Page 39: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/39.jpg)
Volume vs.Time Curve
Expiration
SEC
800 ml
2 3 4 5 61
VT
![Page 40: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/40.jpg)
Typical Volume Curve
1 2 3 4 5 6
SEC
1.2
-0.4
VT
Liters
I-Time
E-Time
A B
A = inspiratory volume
B = expiratory volume
![Page 41: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/41.jpg)
Leaks
1 2 3 4 5 6
SEC
1.2
-0.4
VT
Liters
A
A = exhalation that does not return to zero
![Page 42: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/42.jpg)
1 2 3 4 5 6
SEC
1 2 3 4 5 6
VT
600 cc
120
120
SEC
.V
LPM
0
450 cc
Setting Appropriate I-Time
![Page 43: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/43.jpg)
Setting Appropriate I-Time
500 cc450 cc
Lost VT
1 2 3 4 5 6
SEC
1 2 3 4 5 6
VT
600 cc
120
120
SEC
.V
LPM
0
![Page 44: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/44.jpg)
Loops
• Pressure-Volume Loops
• Flow-Volume Loops
![Page 45: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/45.jpg)
Pressure-Volume Loop
0 20 40 602040-60
0.2
LITERS
0.4
0.6
Paw
cmH2O
VT
![Page 46: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/46.jpg)
Mandatory Breath
Inspiration
0 20 40 602040-60
0.2
LITERS
0.4
0.6
Paw
cmH2O
VT
![Page 47: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/47.jpg)
Mandatory Breath
Expiration
0 20 40 602040-60
0.2
LITERS
0.4
0.6
Paw
cmH2O
Inspiration
VT Counterclockwise
![Page 48: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/48.jpg)
Spontaneous Breath
Inspiration
0 20 40 602040-60
0.2
LITERS
0.4
0.6
Paw
cmH2O
VT
Clockwise
![Page 49: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/49.jpg)
Spontaneous Breath
Inspiration
Expiration
0 20 40 602040-60
0.2
LITERS
0.4
0.6
Paw
cmH2O
VT
Clockwise
![Page 50: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/50.jpg)
Work of Breathing
0 20 40 60-20-40-60
0.2
0.4
0.6
LITERS
Paw
cmH2O
VT
![Page 51: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/51.jpg)
Assisted Breath
0 20 40 602040-60
0.2
LITERS
0.4
0.6
Paw
cmH2O
Assisted Breath
VT
![Page 52: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/52.jpg)
Assisted Breath
Inspiration
0 20 40 602040-60
0.2
LITERS
0.4
0.6
Paw
cmH2O
Assisted Breath
VT
![Page 53: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/53.jpg)
Assisted Breath
Inspiration
Expiration
0 20 40 602040-60
0.2
LITERS
0.4
0.6
Paw
cmH2O
Assisted Breath
VT Clockwise to Counterclockwise
![Page 54: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/54.jpg)
Pressure-Volume Loop Changes
0 20 40 60-20-40-60
0.2
0.4
0.6
LITERS
Paw
cmH2O
VT
![Page 55: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/55.jpg)
Changes in Compliances
Indicates a drop in compliance
(higher pressure for the same
volume)
0 20 40 602040-60
0.2
0.4
0.6
LITERS
Paw
cmH2O
VT
![Page 56: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/56.jpg)
Overdistension
B
A
0 20 40 60-20-40-60
0.2
0.4
0.6
LITERS
Paw
cmH2O
C
A = inspiratory pressure
B = upper inflection point
C = lower inflection point
VT
![Page 57: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/57.jpg)
Lung Overdistension
![Page 58: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/58.jpg)
Normal Flow-Volume Loops
![Page 59: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/59.jpg)
Flow -Volume Loops
Volume Control
Volume
Tidal Volume
Inspiration
Expiration
![Page 60: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/60.jpg)
Flow -Volume Loops
Volume Control
Volume
Peak Expiratory Flow
Peak Inspiratory Flow
Tidal Volume
Inspiration
Expiration
![Page 61: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/61.jpg)
ETT or Circuit Leaks
![Page 62: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/62.jpg)
Obstructive Pattern
![Page 63: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/63.jpg)
Bronchodilator Response
2
1
1
2
3
3
V
LPS
.
BEFORE
V
LPS
.
![Page 64: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/64.jpg)
Bronchodilator Response
2
1
1
2
3
3
V
LPS
.
BEFORE AFTER
Worse
2
1
1
2
3
3
V
LPS
.
![Page 65: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/65.jpg)
Bronchodilator Response
2
1
1
2
3
3
V
LPS
.VT
INSP
EXH
BEFORE AFTER
Worse Better
2
1
1
2
3
3
V
LPS
.
2
1
1
2
3
3
V
LPS
.
![Page 66: Waveforms, lecture about mechanical ventilation, by Prof Ahmed Tarek, Prof of Pediatrics, Abu El rich hospital, Cairo university](https://reader033.fdocuments.us/reader033/viewer/2022051414/55a517b31a28abd07f8b475d/html5/thumbnails/66.jpg)
Remember!Waveforms and loops are graphical representation of the data
generated by the ventilator.
Typical Tracings
Pressure-time,
Flow-time,
Volume -time
Loops
Pressure-Volume
Flow-Volume
Assessment of pressure, flow and volume
waveforms is a critical tool in the management of
the mechanically ventilated patient.